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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435201796
Report Date: 08/11/2023
Date Signed: 08/11/2023 10:03:02 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/01/2022 and conducted by Evaluator Christine Dolores
COMPLAINT CONTROL NUMBER: 26-AS-20221101115325
FACILITY NAME:NUEVA VISTAFACILITY NUMBER:
435201796
ADMINISTRATOR:WEINSTEIN, MICHAELFACILITY TYPE:
735
ADDRESS:18225 HALE AVENUETELEPHONE:
(408) 465-8280
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:72CENSUS: DATE:
08/11/2023
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Makel AliTIME COMPLETED:
10:05 AM
ALLEGATION(S):
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Facility staff made inappropriate comments to client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the finding of the above allegation. LPA met with Assistant Administrator, Makel Ali.

On 11/01/2022, the Department received the complaint. On 11/09/2022, the initial complaint investigation was conducted. It was alleged that staff had sexually harassed resident (R1) by expressing their romantic feelings.

Documents were obtained to include the facility resident roster, personnel report, R1 – R6’s physician’s report, appraisal/needs and services plan, and personal rights form.

From 11/09/2022 – 08/10/2023, 6 residents, 3 staff, and 1 witness were interviewed.

SEE LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 26-AS-20221101115325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: NUEVA VISTA
FACILITY NUMBER: 435201796
VISIT DATE: 08/11/2023
NARRATIVE
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Based on resident interview, 5 out of 6 residents denied staff making inappropriate comments by expressing their romantic feelings. 5 out of 6 residents denied observing a staff make inappropriate comments to another resident regarding romantic feelings. 5 out of 6 residents denied telling a staff to like a resident.

Based on staff interview, 3 out of 3 staff members denied making inappropriate comments by expressing their romantic feelings to a resident. 3 out of 3 staff members denied observing another staff make inappropriate comments to a resident.

Based on witness interview, 1 out of 1 witness states R1 has verbalized their concern of staff making inappropriate comments in which none of the allegations were found to be true.

The review of records state R1 experiences symptoms which may result in accusations of abuse and reports of victimization. The facility has addressed a plan and objective to help meet R1’s needs.

The Department has investigated the above allegation and based on record review, interview, and observation the above allegation is unsubstantiated. An unsubstantiated finding indicates that although the allegation may have happened and/or is valid there is not a preponderance of evidence to prove the alleged violations did or did not occur. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Assistant Administrator, Makel Ali and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2